Description and brand name

Drug Information Provider: Merative, Micromedex ®

American brand name

1. Fortamette
2. Phage
3. Glucophage XR
4. joke
5. Riomet
6. Riomet ER

canadian brand name

1. ACTMetformin
2. AG-metFORMIN - BlackBerry
3. AG-metFORMIN - Odorless
4. apolipometformin
5. apolipometformin
6. Oro metformin
7. AVA metformin
8. Biometformin
9. domitfomin

describe

Metformin is used to treat high blood sugar caused by a type of diabetes or sugar diabetes called type 2 diabetes. With this type of diabetes, the insulin produced by the pancreas is unable to carry sugar into the body's cells, preventing them from functioning properly. Metformin alone, along with an oral antidiabetic drug called a sulfonylurea or insulin, will help lower blood sugar that is too high and help restore the way food is used to produce energy.

Many people can control type 2 diabetes through diet and exercise. When you have diabetes, it is always important to follow a specially planned diet and exercise program, even if you are taking medications. To work properly, the amount of metformin you take must be balanced with the amount and type of food you eat and the amount of exercise you get. If you change your diet or exercise, you will need to test your blood sugar to determine if it is too low. If this happens, your doctor will teach you what to do.

Metformin does not help people with insulin-dependent or type 1 diabetes because their pancreas cannot produce insulin. Their blood sugar is best controlled with insulin injections.

This medicine can only be purchased with a doctor's prescription.

This product is available in the following dosage forms:

• Tablet, extended release version
• Suspension, extended release
• pill
• solution
• tablet, extended release, 24 hours

before use

When deciding to use a medication, the risks and benefits of taking the medication must be weighed. This is a decision you and your doctor will make. For this drug, the following factors should be considered:

allergy

Tell your doctor if you have ever had any unusual or allergic reaction to this or any other medicine. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For over-the-counter products, read the label or package ingredients carefully.

Pediatrics

Appropriate studies performed to date have not demonstrated pediatric-specific issues that would limit the use of metformin oral solution, extended-release oral suspension, and tablets in children 10 to 16 years of age. However, the safety and effectiveness of metformin extended-release tablets in the pediatric population have not been established.

Geriatrics

Although appropriate studies on the relationship between age and the effects of metformin have not been conducted in the elderly population, problems specific to the elderly are not expected to limit the use of metformin in the elderly. However, older patients are more likely to develop age-related kidney problems, so caution may be needed in patients receiving metformin. This drug is not recommended for people 80 years and older who have kidney problems.

breast-feeding

There have not been adequate studies in women to determine the risk to the infant when this medication is used during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

drug interactions

Although some drugs should not be used together at all, in other cases two different drugs can be used together even though an interaction is possible. In these cases, your doctor may want to change the dosage, or may need to take other precautions. It is especially important that your health care professional knows if you are taking any of the following medicines while you are taking this medication. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

It is not recommended to use this medicine with any of the following medicines. Your doctor may decide not to treat you with this medication or change some other medications you take.

• acetic acid
• Diatrizoate
• Ethyl sulfide oil
• Iodobenzoic acid
• iodobitol
• locaric acid
• Acetoacetic acid
• Iodamide
• iopan
• iodixanol
• Iodized hippuric acid
• iodopyridine
• Iodoxamic acid
• Glycyrrhizinate
• glycine
• iohexol
• iomepropanol
• iopamidol
• Iopanoic acid
• iodopentol
• Iodophenyl ethyl ester
• Isopropionic acid
• Iosic acid
• Iodomet
• Iotas
• chaotaramat
• eotroland
• Iodokoric acid
• Iodoxamine
• iodosamic acid
• iodoboda
• Metrazine
• Chuanying acid
• sodium tyrosine

Using this medication with any of the following medicines is usually not recommended, but may be needed in some cases. If two drugs are prescribed at the same time, your doctor may change the dose or how often you use one or both drugs.

• Abiraterone acetate
• Acetazolamide
• Alogliptin
• aspirin
• Bepagliflozin
• bictegravir
• Brinzolamide
• Bupropion
• capmatinib
• Chloroquine
• chlorpropamide
• Cimetidine
• Ciprofloxacin
• dashabwe
• delafloxacin
• dichlorphenamide
• Dofetilide
• dolutegravir
• Dorzolamide
• Enoxacin
• fedratinib
• fexinidazole
• Gatifloxacin
• Jimmyfloxacin
• Glimepiride
• Glipizide
• Excellent hypoglycemic
• gpafloxacin
• Hydroxychloroquine
• iopromide
• ioversol
• isavuconazole
• Lanreotide
• Levofloxacin
• Levoketoconazole
• Liraglutide
• Lomefloxacin
• Methazolamide
• moxifloxacin
• Naglina
• Norfloxacin
• Octreotide
• Ofloxacin
• ombitasvir
• paretaprevir
• pariseptide
• pioglitazone
• Ranolazine
• repaglinide
• Semaglutide
• sitagliptin
• somatrogongra
• Soxgliflozin
• Sparfloxacin
• tafenoquin
• lipoic acid
• Tolasulfonamide
• tolbutamide
• topiramate
• trovafloxacin
• Vandetanib
• Zonisamide

Using this medication with any of the following medicines may increase your risk of certain side effects, but taking both medicines together may be the best treatment for you. If two drugs are prescribed at the same time, your doctor may change the dose or how often you use one or both drugs.

• acebutolol
• atenolol
• Betaxolol
• bisoprolol
• Momordica charantia
• carteolol
• carvedilol
• Celilor
• colavilan
• Esmolol
• Fenugreek
• Glucomannan
• Guar gum
• isocarboxazid
• labelore
• Levobunolol
• linezolid
• Methylene blue
• Metyrolol
• Metoprolol
• Nadolol
• Nebivolol
• Oxyprenolol
• Ozanimod
• Patty Romer
• Spray Bolol
• Phenelzine
• Pindolol
• Pralor
• procarbazine
• propranolol
• Plantago
• Resagiline
• rifampicin
• safinamide
• Silaijilan
• Sotalol
• timolol
• Tranylcypromine
• Verapamil

Other interactions

Certain medications should not be used with or around eating or eating certain types of food because interactions may occur. Using alcohol or tobacco with certain medications may also cause interactions. The following interactions have been selected based on their potential significance and are not necessarily all-inclusive.

Other medical problems

The presence of other medical problems may affect the use of this medication. Be sure to tell your doctor if you have any other medical problems, especially:

• alcohol, overuse or
• Adrenal insufficiency or
• Hypopituitary gland function or
• malnutrition or
• Physical condition becomes weak or
• Any other condition that causes hypoglycemia—Patients with these conditions may be more susceptible to hypoglycemia while taking metformin.

• Anemia (low levels of red blood cells) or
• Vitamin B12 Deficiency - Use with caution. may make these conditions worse.

• acute or unstable congestive heart failure or
• Dehydrated or
• heart attack, acute or
• hypoxemia (reduced oxygen in the blood) or
• kidney disease or
• liver disease or
• sepsis (blood poisoning) or
• Shock (low blood pressure, poor circulation) - A rare condition called lactic acidosis may occur. If you have concerns about this, talk to your doctor.

• Diabetic ketoacidosis (ketones in the blood) or
• kidney disease, severe or
• metabolic acidosis (excess acid in the blood) or
• Type 1 Diabetes - It should not be used by patients with these conditions.

• fever or
• infection or
• surgery or
• Trauma — These conditions may cause temporary problems with blood sugar control, and your doctor may need to treat you with insulin.

Proper use

This medication usually comes with a patient information insert. Before taking this medicine, read the information carefully and make sure you understand it. If you have any questions, please consult your doctor.

Carefully follow the special meal plan your doctor gives you. This is a very important part of managing the condition and is necessary if the medication is to work properly. Additionally, exercise regularly and test your blood or urine for sugar as directed.

Metformin should be taken with food to help reduce stomach or intestinal side effects that may occur during the first few weeks of treatment.

Swallow the tablet or extended-release tablet whole with a full glass of water. Do not crush, break or chew it.

When you take extended-release tablets, some of the tablets may pass into your stool after your body absorbs the medicine. This is normal and nothing to worry about.

Measure oral solutions with labeled measuring spoons, oral syringes, or medicine cups. A regular household teaspoon may not hold the right amount of liquid.

Measure mixed extended-release oral suspension using the dosage cup provided. If you do not have a dosing cup, ask your pharmacist for one.

Use only the brand of this medication prescribed by your doctor. Different brands may work differently.

You may notice improvements in blood sugar control within 1 to 2 weeks, but the full effects of blood sugar control may take up to 2 to 3 months. If you have any questions about this, please ask your doctor.

dose

The dosage of this drug will vary for different patients. Follow your doctor's instructions or the directions on the label. The information below contains only average doses of this drug. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine you take depends on the strength of the medicine. Additionally, the daily dose you take, the time allowed between doses, and the length of time you take the medication depend on the medical problem for which you are using the medication.

• For type 2 diabetes:
  • For oral dosage form (extended-release tablets):
    • Adult-
      • Metformin (Fortamet®) alone: ​​First, take 1,000 milligrams (mg) once daily with dinner. If needed, your doctor may increase your dose until your blood sugar is under control. However, the dose usually does not exceed 2500 mg per day.
      • Metformin (Glucophage® XR) alone: ​​First, take 500 mg once daily with dinner. If needed, your doctor may increase your dose until your blood sugar is under control. However, the dose usually does not exceed 2,000 mg per day.
      • Metformin (Glumetza®) alone: ​​First, take 500 mg once daily with dinner. Then, if needed, your doctor may increase your dose until your blood sugar is under control. However, the dose usually does not exceed 2,000 mg per day.
      • Metformin vs. sulfonylureas: Your doctor will determine the dosage of each drug.
      • Metformin with insulin: Initially, 500 mg once daily. Then, if needed, your doctor may increase your dose by 500 mg each week until your blood sugar is under control. However, the dose usually does not exceed 2500 mg per day.
    • Children - Use and dosage must be determined by your doctor.
  • For oral dosage forms (extended-release suspension):
    • Adults - Initially, take 5 milliliters (mL) once daily with the evening meal. If needed, your doctor may increase your dose by 5 mL each week until your blood sugar is under control. But the daily dose usually does not exceed 20 ml.
    • Children 10 to 16 years - Initially, take 5 ml once daily with dinner. If needed, your doctor may increase your dose by 5 mL each week until your blood sugar is under control. But the daily dose usually does not exceed 20 ml.
    • Children under 10 years of age - Use and dosage must be determined by your doctor.
  • For oral dosage forms (solutions):
    • Adult-
      • To use metformin alone: ​​First, take 5 milliliters (mL) twice a day or 8.5 mL once a day with a meal. If needed, your doctor may increase your dose until your blood sugar is under control. However, the dose usually does not exceed 25.5 ml per day.
      • Metformin vs. sulfonylureas: Your doctor will determine the dosage of each drug.
      • Metformin with insulin: Initially, 5 mL once daily. If needed, your doctor may increase your dose until your blood sugar is under control. But the daily dose usually does not exceed 25 ml.
    • Children 10 to 16 years - Initially, take 5 ml twice daily with food. If needed, your doctor may increase your dose until your blood sugar is under control. But the daily dose usually does not exceed 20 ml.
    • Children under 10 years of age - Use and dosage must be determined by your doctor.
  • For oral dosage forms (lozenges):
    • Adult-
      • Taking metformin alone: ​​First, take 500 milligrams (mg) twice a day with breakfast and dinner, or 850 mg a day with breakfast. If needed, your doctor may increase your dose until your blood sugar is under control. Your doctor may then ask you to take 500 or 850 mg two to three times a day with meals. However, the dose usually does not exceed 2550 mg per day.
      • Metformin vs. sulfonylureas: Your doctor will determine the dosage of each drug.
      • Metformin with insulin: 500 mg daily initially. If needed, your doctor may increase your dose by 500 mg each week until your blood sugar is under control. However, the dose usually does not exceed 2500 mg per day.
    • Children 10 to 16 years of age - Initially, take 500 mg twice daily after breakfast. If needed, your doctor may increase your dose until your blood sugar is under control. However, the dose usually does not exceed 2,000 mg per day.
    • Children under 10 years of age - Use and dosage must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and return to your regular dosing schedule. Do not double the dose.

storage

Store medication in an airtight container at room temperature, away from heat, moisture, and direct light. Avoid freezing.

Keep out of reach of children.

Do not keep expired medications or medications that are no longer needed.

Ask your health care professional what to do with any medicines you don't use.

Precaution

It is very important that your doctor check you or your child's progress at regular visits, especially during the first few weeks you take this medication. Blood and urine tests may be needed to check for adverse effects.

This drug may interact with the dyes used in X-rays or CT scans. Your doctor should advise you to stop taking it before having any medical tests or diagnostic tests that may cause you to produce less urine than usual. If your kidney function test results are normal, you may be advised to start taking your medicine again 48 hours after the test or test.

Make sure that any doctor or dentist who treats you knows that you are using this medication. You may need to stop using this medication several days before surgery or medical tests.

It is important to carefully follow any instructions from your healthcare team about:

• Alcohol - Drinking alcohol may cause severe hypoglycemia. Discuss this with your health care team.
• Other medicines - Do not take other medicines unless discussed with your doctor. This especially includes over-the-counter medicines such as aspirin, and medicines used to control appetite, asthma, colds, coughs, hay fever, or sinus problems.
• Counseling - Other family members need to learn how to prevent side effects or assist if they occur. Additionally, patients with diabetes may need special counseling regarding changes in diabetes medication dosage that may occur due to lifestyle changes, such as exercise or dietary changes. Because people with diabetes can have problems during pregnancy, they may need counseling about birth control and pregnancy.
• Travel – Carry recent prescriptions and medical history with you. Prepare for emergencies as you normally would. Account for time zone changes and keep meal times as close to your usual meal times as possible.
• In an emergency - Sometimes you may need emergency assistance for problems caused by diabetes. You need to be prepared for these emergencies. It is best to wear a medical identification (ID) bracelet or necklace at all times. Also, carry an identification card in your purse or purse that states you have diabetes and lists all your medications.

In some cases, too much metformin can cause lactic acidosis. Symptoms of lactic acidosis are severe and appear quickly, often when other serious health problems unrelated to the drug are present, such as a heart attack or kidney failure. Symptoms of lactic acidosis include abdominal or stomach discomfort, loss of appetite, diarrhea, fast or shallow breathing, general malaise, severe muscle pain or cramps, unusual drowsiness, tiredness, or weakness.

If symptoms of lactic acidosis occur, seek emergency medical assistance immediately.

This medication may cause ovulation in some premenopausal women who have irregular periods. This can increase the chance of pregnancy. If you are a woman of childbearing potential, you should discuss birth control options with your doctor.

This medicine may cause hypoglycemia (low blood sugar). This condition is more common when this medication is taken with certain medications. Low blood sugar must be treated before it causes you to pass out (lose consciousness). People experience different symptoms of hypoglycemia. It's important to know what symptoms you typically have so you can treat them quickly. Talk to your doctor about the best ways to treat low blood sugar.

High blood sugar can occur if you don't take enough medicine or miss a dose, eat too much or don't follow your meal plan, have a fever or infection, or don't exercise as usual. High blood sugar can be serious and must be treated immediately. It's important to know what symptoms you have so you can get treatment quickly. Talk to your doctor about the best ways to treat high blood sugar.

High blood sugar can occur if you don't exercise as much as usual, have a fever or infection, don't take enough or skip a dose of diabetes medication, eat too much, or don't follow your eating plan.

side effect

In addition to their desired effects, medications may cause some adverse effects. Although not all of these side effects will occur, if they do occur, they may require medical attention.

Consult your doctor immediately if any of the following side effects occur:

relatively common; generally

1. Abdominal or stomach discomfort
2. Cough or hoarse voice
3. decreased appetite
4. diarrhea
5. Breathing quickly or shallowly
6. fever or chills
7. general feeling of discomfort
8. lower back or side pain
9. muscle pain or cramps
10. Pain or difficulty urinating
11. sleepy

Unusual

1. anxiety
2. blurry vision
3. Chest discomfort
4. break out in cold sweat
5. coma
6. Confused
7. Cool, pale skin
8. frustrated
9. Difficulty or labored breathing
10. Dizziness
11. A fast, irregular, pounding, or rapid heartbeat or pulse
12. warm feeling
13. Headache
14. increased hunger
15. increased sweating
16. nausea
17. nervous
18. nightmare
19. Redness of the face, neck, arms, and occasionally the upper chest
20. epileptic seizure
21. tremble
22. unclear speech
23. Chest tightness
24. unusual tiredness or weakness

rare

1. Behavioral changes similar to drunkenness
2. difficulty concentrating
3. drowsiness
4. lack or loss of strength
5. disturbed sleep
6. unusual drowsiness

Some side effects may occur that usually do not require medical attention. These side effects may go away during treatment as your body adjusts to the medication. Additionally, your health care professional may be able to tell you ways to prevent or reduce some of these side effects. If any of the following side effects persist or are bothersome, or if you have any questions about them, talk to your health care professional:

relatively common; generally

1. Stomach acid or acid
2. Hiccups
3. Bloated
4. excess air or gas in the stomach or intestines
5. full feeling
6. Heartburn
7. indigestion
8. Loss of appetite
9. Metallic taste in mouth
10. gas passes
11. stomach ache
12. Stomach upset or pain
13. Vomit
14. lose weight

Unusual

1. Abnormal stool
2. bad, unusual or unpleasant (after) taste
3. Taste changes
4. Difficulty moving
5. discoloration of fingernails or toenails
6. flu-like symptoms
7. joint pain
8. rash
9. sneeze
10. Congested or runny nose
11. swollen joints

Some patients may also experience other side effects not listed. If you notice any other effects, consult your healthcare professional.